Nicole Hanratty, CEAP, SAP Senior Account Manager x200 American Substance Abuse Professionals ® | GO2ASAP.COM

Agenda Part 1: Part 1: Cheating a Urine Drug Screen Part 2: Part 2: Emerging Drugs of Abuse Part 3: Part 3: Q&A American Substance Abuse Professionals® 2014 All Rights Reserved

Cheating a Urine Drug Screen Part 1 American Substance Abuse Professionals® 2014 All Rights Reserved

Top 10 Reasons Someone Tested Positive 10. I handle a lot of money, so the cocaine must have been on the money. 9. I took my wife’s pain medication because I hurt my back, doing well you know… 8. I went to a Grateful Dead Concert and got a contact high from others around me. 7. I ate a brownie at a party, that must have been the reason I tested positive. 6. I sell cocaine but I don’t use it. It must of absorbed through my hands. 5. The vinegar in my salad dressing made me test positive for alcohol. 4. Strippers and prostitutes… enough said. 3. Someone high jacked my truck and forced me to smoke crack. 2. It doesn’t count if you smoke it in Jamaica. 1. There is no way I tested positive for cocaine, I only smoke weed. The urine I bought online must have been dirty.

Adulterated Specimens For over 20 years, people have been using household products as a way to “cheat” a urine drug test. The following household items change urine's pH, or acidity, which makes the sample useless for testing: ◦Vinegar ◦Lemon juice ◦Drain-cleaning products ◦Laundry detergent ◦Baking soda ◦Salt ◦Bleach ◦Eye drops American Substance Abuse Professionals® 2014 All Rights Reserved

Mid Stream Collection ◦The beginning and end of stream carry more metabolites so that’s where they are more likely to detect the drugs. Middle of stream is less detectable. So some users may only use the middle stream. American Substance Abuse Professionals® 2014 All Rights Reserved

“Detoxifying” Products There are many “detoxifying” drinks that are available online. Most of the drinks are just loaded with caffeine and come with instructions to drink a lot of water. Pyridinium chlorochromate (PCC) is a chemical that can be found in some “detoxifying” drinks, which destroys drug molecules in urine. Adding hydrogen peroxide will turn a PCC-containing urine sample dark brown. Drinking a large amount of water will dilute the specimen. A sample below a certain concentration cannot be tested and therefore the lab will report the result as “diluted”.

“Detoxifying” Drinks American Substance Abuse Professionals® 2014 All Rights Reserved

“Detoxifying” Products Detox gels- “Designed to safely and quickly remove toxins that have built up in your system.” Detox shampoo- “Cleanses Hair Quickly of Chemical Residue Buildup.”

Fake Urine Samples Human urine is available for purchase online. Testclear.com is just one site that offers a powder urine kit for $44. The kit comes with drug-free powdered urine, a 50-ml plastic medical vial, an air-activated heater that last six hours, a temperature strip and an instruction sheet that includes hints and tips. American Substance Abuse Professionals® 2014 All Rights Reserved

Urination Devices

Emerging Drugs of Abuse Part 2 American Substance Abuse Professionals® 2014 All Rights Reserved

Synthetic Marijuana Synthetic marijuana utilizes analogs of tetrahydrocannabinol (THC) which is the psychoactive ingredient in marijuana. They are often marketed as incense or potpourri and labeled as not for human consumption. The actual ingredients are rarely listed and the brand names and packaging can vary widely. American Substance Abuse Professionals® 2014 All Rights Reserved

Synthetic Marijuana In March of 2011, the U.S. DEA placed five of the most commonly seen synthetic marijuana compounds on the list of controlled substances under Schedule 1 of the Controlled Substances Act: JWH-018; JWH-073; JWH-200; CP- 47,497 and C8 homologs. In 2012, that list was expanded to include 20 more compounds. On January 10, 2014, the DEA temporarily placed 4 more compounds on the list of Schedule 1 Controlled Substances. American Substance Abuse Professionals® 2014 All Rights Reserved

Brand Names Include: K2 Spice Purple Haze Kryptonite Potpourri Silver Happy Hour, Wicked XXX, Purple Magic Klimax Kush Mr. Happy Skunk Spike 99 Bliss K3 K7 K9 Cloud Nine Mad Hatter Tsunami Black Mamba Krazy Kush Posh Yucatan Fire Genie Kush American Substance Abuse Professionals® 2014 All Rights Reserved

Effects Include: Spice users report experiences similar to those produced by marijuana—elevated mood, relaxation, and altered perception—and in some cases the effects are even stronger than those of marijuana. Some users report extreme anxiety along with psychotic- like effects including paranoia and hallucinations. Because the chemical compositions of many products sold as Spice are unknown, it is likely that some varieties also contain substances that could cause dramatically different effects than the user might expect. American Substance Abuse Professionals® 2014 All Rights Reserved

Health Impacts Elevated blood pressure Rapid heart rate Vomiting Agitation Seizures Confusion Hallucinations Non-responsiveness Death American Substance Abuse Professionals® 2014 All Rights Reserved

Increased Usage The American Association of Poison Control Centers National Poison Data System (NPDS) reported 2,096 calls about synthetic marijuana products in 2010; 6,959 calls in 2011; and 5,230 in * Includes 57 national poison centers reporting data, including the Illinois Poison Center. American Substance Abuse Professionals® 2014 All Rights Reserved

K2 Spice Packaging

Synthetic Marijuana American Substance Abuse Professionals® 2014 All Rights Reserved

Cathinone Derivatives/ Bath Salts The cathinone drugs affect the brain in ways very similar to methamphetamine, ecstasy or cocaine. They are sold as bath salts, plant food, screen cleaner or research chemicals and are clearly labeled “not for human consumption”. Common synthetic cathinones found in bath salts include 3,4-methylenedioxypyrovalerone (MDPV), mephedrone (“Drone,” “Meph,” or “Meow Meow”), and methylone but there are many others. American Substance Abuse Professionals® 2014 All Rights Reserved

Cathinone Derivatives/ Bath Salts Bath salts typically take the form of a white or brown crystalline powder. Bath salts are typically taken orally, inhaled, or injected, with the worst outcomes being associated with snorting or needle injection. In July 2012, President Obama signed legislation permanently making two of them—mephedrone and MDPV—illegal in addition to several chemically similar compounds. American Substance Abuse Professionals® 2014 All Rights Reserved

Effects of Bath Salts Consistent with other drugs like amphetamines and cocaine that raise the level of dopamine, bath salts have an energizing and agitating effect. A surge in dopamine in these circuits causes feelings of euphoria and increased activity. A recent study found that MDPV raises brain dopamine in the same manner as cocaine but is at least 10 times more potent. A recent analysis of the effects of mephedrone and methylone in rats showed that these drugs raised levels of serotonin in a manner similar to MDMA, creating hallucinations. American Substance Abuse Professionals® 2014 All Rights Reserved

Health Impacts Increased heart rate Elevated blood pressure Heart and chest pains Seizures Dehydration Breakdown of skeletal muscle tissue Kidney and liver failure Increased risk of suicide Long term mental illness Death American Substance Abuse Professionals® 2014 All Rights Reserved

Brand Names Tranquility Serenity Eight Ballz Ivory Wave Charlie Sheen Cloud Nine White Lightening Plant Food Bloom Lunar Wave Vanilla Sky Scarface Ocean Snow Blue Mystic T-7 Tripstacy American Substance Abuse Professionals® 2014 All Rights Reserved

Cathinone Derivatives/ Bath Salts American Substance Abuse Professionals® 2014 All Rights Reserved

The Impact of Designer Drug Use November 12, 2010, Dickie Sanders, 21, committed suicide two days after snorting 1 gram of Cloud 9 Bath Salts. The Bath Salts were not detectable in his drug and blood test results. 27 BATH SALTS Photo:

Synthetic Hallucinogens: Smiles “Smiles” is the street name for a new synthetic drug known as 2C-I. 2C-I is part of the 2C family of drugs, a group of closely related molecules that have psychedelic effects. 2C-I was discovered by chemist and synthetic-drug guru Alexander Shulgin, who published the formulas of psychoactive drugs in his book "PiHKAL: A Chemical Love Story" (Transform Press, 1991). As of July 2012, the Drug Enforcement Administration classifies 2C-I as a Schedule I controlled substance, making it illegal to manufacture, buy, sell or possess the drug. American Substance Abuse Professionals® 2014 All Rights Reserved

Synthetic Hallucinogens: Smiles 2C-I typically comes in a powder form but may also be liquid or in a pill form. The drug can be taken orally, smoked, snorted or injected. Side effects may include dilated pupils, high energy, muscle relaxation or tension, nausea and vomiting. In larger doses, the user may experience psychedelic or visual and auditory hallucinations. American Substance Abuse Professionals® 2014 All Rights Reserved

Synthetic Hallucinogens: Smiles 2C drugs cause hallucinations by interfering with the brain's serotonin system; however unlike other hallucinogens they also have stimulant effects. 2C drugs can harm users in the same ways as meth and other amphetamines. The drug has been linked to fatalities in the US, including 2 teenagers in North Dakota as well as a known actor in Los Angeles. Brand names: Smiles, 2C-E, 2C-D, 2C-I, 2C-T-2, 2C-T-4, 2C-H, 2C-N, 2C-P American Substance Abuse Professionals® 2014 All Rights Reserved

Synthetic Hallucinogens: Smiles American Substance Abuse Professionals® 2014 All Rights Reserved

Testing for Synthetic Drugs of Abuse Synthetic Cannabanoids: There is testing for most of the Schedule I compounds. The tests currently vary in the number of compounds tested for – early testing was limited to the original 5 compounds prohibited. Currently, urine screens are available for most of the banned substances in a single sample. Cathinones: Urine drug screening is available for the following - MDPV, Mephedrone, Methylone, Naphyrone, Methedrone, Butylone, Methcathinon, and Ethylone. 2C drugs: No testing available American Substance Abuse Professionals® 2014 All Rights Reserved

What is Molly? Molly is the powder or crystal form of MDMA, which is the main chemical used in Ecstasy Molly is claimed to be the pure form of MDMA The DEA labels it a Schedule 1 controlled substance making it illegal to buy, use or posses Molly Molly is typically sold in capsules Average cost is $20-$50 per capsule American Substance Abuse Professionals® 2014 All Rights Reserved

Effects of Molly The drug’s effects last approximately 3 to 6 hours After taking Molly, the user may experience: ◦Increased energy ◦Euphoria ◦Emotional warmth, closeness and empathy toward others ◦Distortions in sensory and time perception American Substance Abuse Professionals® 2014 All Rights Reserved

Health Risks Increased heart rate and blood pressure Muscle tension Involuntary teeth clenching Nausea Blurred vision Faintness Chills and/or sweating Liver, kidney, or cardiovascular system failure Death American Substance Abuse Professionals® 2014 All Rights Reserved

Negative After Effects The user may experience negative after effects that can occur anytime after taking the drug until weeks later. Some after effects may include: ◦Confusion ◦Depression ◦Sleep problems ◦Drug craving ◦Anxiety American Substance Abuse Professionals® 2014 All Rights Reserved

Impact of Molly Molly is not necessarily a new drug. MDMA has been around since the early 1900’s and was classified as an illegal substance in Over the last couple of years “Molly” has become a popular drug, particularly at music festivals, and is being thought of as a pure and safe substance. Musicians like Madonna, Miley Cyrus, and Kanye West have included lyrics in songs or talked about using Molly which has made the drug more appealing. There have been multiple overdoses including four people who died during the summer of 2013 after using Molly. The number of visits to U.S. emergency rooms involving MDMA has jumped 123 percent since 2004, according to data compiled by the Drug Abuse Warning Network. American Substance Abuse Professionals® 2014 All Rights Reserved

MDMA and the DOT Effective October 1, 2010, the DOT published a final rule which mandates preliminary laboratory testing for MDMA as part of the amphetamine panel. American Substance Abuse Professionals® 2014 All Rights Reserved

What's coming… Krokodil Crock: ‘Flesh-Eating Zombie Drug’ 2C-E: more dangerous then 2C-I MDAI: “Sparkle” or “mindy” Bromo-Dragonfly: similar to LSD but can last for up to 3 days

Nicole Hanratty, CEAP, SAP Senior Account Manager x200 Question & Answer /Conclusion Thank You! American Substance Abuse Professionals® 2014 All Rights Reserved